Document Type



Doctor of Nursing Practice



Date of Defense


Graduate Advisor

Laura Kuensting


Louise Miller

Keri Jupka


Problem: To ensure safe participation in youth athletics and prevent COVID-19 transmission during the COVID-19 pandemic, St. Louis County Department of Public Health (DPH) implemented Youth Sports Guidelines on October 14, 2020. This project aimed to identify level of adherence to precautions listed in the guidelines at six county public high school athletic events.

Methods: An observational descriptive study design was used to monitor guideline adherence at high school athletic events. Two observers tallied violations by participants and spectators to Youth Sports Guidelines at St. Louis County public high school athletic events. Six high-frequency contact (basketball and wrestling) events and six low-frequency contact (swimming) athletic events were observed.

Results: Social distancing and mask wearing guideline violations made up 86% of total violations observed at all high school athletic events. Mask violations at high-frequency contact events (basketball and wresting) were significantly higher when compared to low-frequency contact events (alpha value of 0.05, p = .046). Social distance violations for low-frequency contact events when compared to high-frequency contact events were statistically significant (alpha value of 0.05, p = .017). This small study found no significant correlation between total observed guideline violations at high school athletic events and COVID-19 infection case rates.

Implications for practice: Frequent violations to St. Louis County DPH Youth Sports Guidelines were observed in this study. Results of this project may help direct guideline revisions and practice changes to COVID-19 precautions to ensure better compliance and prevent COVID-19 infection transmission in youth athletics.